广州市社区高血压自我管理模式效果评价

目的对广州市黄埔区社区高血压自我管理模式实施6个月后的效果进行评价。方法将312名自愿报名参加该研究的高血压患者随机分为干预组和对照组,其中干预组152人,对照组160人。干预组接受《高血压自我管理指导手册》的管理模式,对照组接受常规的高血压三级管理模式。比较两组高血压患者在项目实施前和实施6个月后的生活方式相关行为、自我效能和血压控制情况。结果项目实施6个月后,干预组知识知晓率为97.4%,生活方式相关行为形成率为71.8%,与干预前(59.8%、57.4%)比较有明显提高,差异有统计学意义(P<0.05),而对照组干预前后比较,差异无统计学意义(P>0.05);干预组服药依从性、体育锻炼、医患交流等自我管理行为及自我管理效能变化值明显好于对照组,差异有统计学意义(P<0.01)。6个月后干预组比对照组平均多降低收缩压约4.71 mm Hg(1 mm Hg=0.133 kPa),舒张压降低约2.17 mm Hg,两组比较,差异均有统计学意义(P<0.01)。结论社区高血压自我管理模式较传统的高血压三级管理模式在改善患者生活方式相关行为、自我管理行为、自我效能、降低血压、提高高血压控制率方面效果更好。

Evaluation of the Effects of Self-management Model on Hypertension in Community of Guangzhou

Objective To evaluate the effects of six-month self-management on hypertension in Huangpu community of Guangzhou.Methods In accordance with randomized controlled trial design,312 patients volunteered for the study of hypertensive were randomly divided into intervention(n=152) and control(n=160) groups.Intervention group received an instruction manual of self-management of hypertension,while the control group received conventional three-level management of hypertension;then compared the changes of the lifestyle-related behavior,self-efficacy and blood pressure control between two groups before and after 6 months of the sutdy.Results After 6 months implementation of the project,knowledge awareness rate was 97.4% and the formation rate of lifestyle-related behaviors was 71.8% in intervention group,which was higher than that before the intervention(59.8% and 57.4%,respectively)(P<0.05),while the control group had little difference before and after intervention.In medication compliance,exercise,doctor-patient communication and other self-management behaviors and self-management change in performance,value,the intervention group significantly was better than the control group(P<0.01).The systolic and diastolic blood pressure in the intervention group after 6 months were about 4.71 mm Hg and 2.17 mm Hg lower than those in the control group(P<0.01).Conclusions Compared with the traditional three-level management model,the self-management model of hypertension in community has better effects on the improvement of lifestyle-related behavior,self-management behavior,self-efficacy,lowering blood pressure,and improving blood pressure control rates.